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Copyright (c) 2024 Maryam Ibrahim Hadi Zabani, Fawaz Abdarab alnaby AL-Qariqri, Ibrahim Yahya Mohamed Alwdani, Rayan Abdullah Ali Almotiri, Naif Hassan Mohammed Alzahrani, Hanan Ali Al Maqadi, Najaw Abduaalh Rashed Alsubai, Najwa Mohammed Ahmed Hadi, Hasnah Ibrahim Mohammed Alqasimi, Saeed Mohammed Alzhrani, Yahya Ali Yahya Alsawadi, Salam Muthes Saif AL-Dosari, Abdulaziz Ahmed Hassan Al-Zahrani Al-Zahrani, Mohammad Yahya Mohammad Al-Wadani, Nouf Mohammed Jubran Al-Subyani, Bandar Mohammed Ramadan Hawsawi
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Role of Nurses in Anesthesia Crisis Resource Management: A Review Study
Corresponding Author(s) : Maryam Ibrahim Hadi Zabani
Saudi Journal of Medicine and Public Health,
Vol. 1 No. 1 (2024)
Abstract
Background: Anesthesia Crisis Resource Management (ACRM), adapted from aviation's Crew Resource Management, enhances patient safety in high-risk perioperative care by emphasizing non-technical competencies like communication and collaboration. Nurses, particularly perioperative nurses and certified registered nurse anesthetists (CRNAs), are key members of multidisciplinary ACRM teams, yet their roles are underinvestigated. Aim: This review evaluates nurses' contributions to ACRM, focusing on patient surveillance and team coordination to reduce perioperative errors. Methods: A narrative synthesis of studies from 2015–2025, sourced from PubMed, Scopus, and Web of Science, was conducted, reviewing historical trends, ACRM principles, role-specific effects, training, and future trends.
Results: Nurses enhance situational awareness, identifying crises early and reducing response times by 20%. Simulation training, including virtual reality, improves team performance by 25–30%. Barriers include nursing workload constraints and hierarchical challenges in the operating room (OR). Conclusion: Nurses are central to ACRM, improving outcomes through vigilant monitoring and effective coordination. Standardized multidisciplinary protocols and AI tool integration in future research could address barriers.
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- Abdu Asiri, B. A., Almutairi, R. M., Alfadhel, R. M., hawsawi, N. N. A., Faqeehi, S. M., & Alshammari, E. M. (2025). Technology-Driven Nursing Interventions to Support Telehealth in Cardiac Primary Care. Saudi Journal of Medicine and Public Health, *2*(2), 137–146. https://doi.org/10.64483/jmph-67
- Alnaji, I. A. J., & Alkhaldi, A. S. M. (2024). The Integral Role of Nursing Informatics in Enhancing Patient Outcomes through the Integration of Health Information Systems in Clinical Practice: Review. Saudi Journal of Medicine and Public Health, *1*(1), 8–15. https://doi.org/10.64483/jmph-15
- Anwar A, Heller KO, Esper SA, Ferreira RG (2021) Nonoperating room anesthesia: strategies to improve performance. International Anesthesiology Clinics 59(4):27–36. DOI: 10.1097/AIA.0000000000000339
- Arriaga AF, Szyld D, Pian-Smith MC (2020) Real-time debriefing after critical events: exploring the gap between principle and reality. Anesthesiology Clinics 38(4):801. https://doi.org/10.1016/j.anclin.2020.08.003
- Arumugam K (2023) The Role of the Community Pharmacists in the Management of Acute Pain in Adults: A Scoping Review. McGill University (Canada).
- Beshbishy, A. M. (2024). Advancements in Vaccination Tracking and Delivery Systems through Health Informatics: A Review of Digital Innovations and COVID-19 Impact. Saudi Journal of Medicine and Public Health, *1*(1), 16 – 26 . https://doi.org/10.64483/jmph-16
- Boet S, Larrigan S, Martin L, Liu H, Sullivan KJ, Etherington C (2018) Measuring non-technical skills of anaesthesiologists in the operating room: a systematic review of assessment tools and their measurement properties. British Journal of Anaesthesia 121(6):1218–1226. https://doi.org/10.1016/j.bja.2018.07.028
- Brewster DJ, Butt WW, Gordon LJ, Sarkar MA, Begley JL, Rees CE (2023) Leadership during airway management in the intensive care unit: A video-reflexive ethnography study. Frontiers in Medicine 10:1043041. https://doi.org/10.3389/fmed.2023.1043041
- Brown M, Schoen JH, Gross J, Omary RA, Hanneman K (2023) Climate change and radiology: impetus for change and a toolkit for action. Radiology 307(4):e230229. https://doi.org/10.1148/radiol.230229
- Burden A, Pukenas EW (2018) Use of simulation in performance improvement. Anesthesiology Clinics 36(1):63–74. https://doi.org/10.1016/j.anclin.2017.10.001
- Dieckmann P, Schmutz JB, Su L (2021) Cognition and decision making in the real world. In Comprehensive Healthcare Simulation: Improving Healthcare Systems (pp. 23–29). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-72973-8_3
- Fallatah, A. R., Hawsawi, A. M. T., Makrami, R. A. H., Makrami, M. A. H., Jaber, S. A. H., Alanazi, K. S. sweet, … Al-Dosari, N. M. H. (2024). The Effect of Climate Change on Nursing: Climate Health Emergencies Preparedness Amidst Extreme Weather Conditions. Saudi Journal of Medicine and Public Health, *1*(1), 123–130. https://doi.org/10.64483/jmph-54
- Gaba DM, Fish KJ, Howard SK, Burden AR (1994) Crisis Management in Anesthesiology. (No Title).
- Goldhaber-Fiebert SN, Merrell SB, Agarwala AV, De La Cruz MM, Cooper JB, Howard SK, Gaba DM (2020) Clinical uses and impacts of emergency manuals during perioperative crises. Anesthesia & Analgesia 131(6):1815–1826.
- Hammontree J, Kinderknecht CG (2022) An in situ mock code program in the pediatric intensive care unit: a multimodal nurse-led quality improvement initiative. Critical Care Nurse 42(2):42–55. https://doi.org/10.4037/ccn2022631
- Kreuter, A. (2023). Improving Nursing Confidence Through Simulated Resuscitation Events in the Neonatal Intensive Care Unit: A Quality Improvement Project (Doctoral dissertation, Jacksonville University).
- Lluch C, Galiana L, Doménech P, Sansó N (2022) The impact of the COVID-19 pandemic on burnout, compassion fatigue, and compassion satisfaction in healthcare personnel: a systematic review of the literature published during the first year of the pandemic. In Healthcare (Vol. 10, No. 2, p. 364). MDPI. https://doi.org/10.3390/healthcare10020364
- Merry AF, Hannam JA, Webster CS, Edwards KE, Torrie J, Frampton C, Weller JM (2017) Retesting the hypothesis of a clinical randomized controlled trial in a simulation environment to validate anesthesia simulation in error research (the VASER Study). Anesthesiology 126(3):472–481. https://doi.org/10.1097/ALN.0000000000001514
- Pasli, M., Tumin, D., & Guffey, R. (2024). Simulation‐Based Analysis of Trial Design in Regional Anesthesia. Anesthesiology Research and Practice, 2024(1), 6651894. https://doi.org/10.1155/2024/6651894
- Patterson ES, Rayo MF, Edworthy JR, Moffatt-Bruce SD (2022) Applying human factors engineering to address the telemetry alarm problem in a large medical center. Human Factors 64(1):126–142. https://doi.org/10.1177/00187208211018883
- Weller JM, Torrie J, Boyd M, Frengley R, Garden A, Ng WL, Frampton C (2014) Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial. British Journal of Anaesthesia 112(6):1042–1049. https://doi.org/10.1093/bja/aet579
- Weinger MB, Banerjee A, Burden AR, McIvor WR, Boulet J, Cooper JB, Gaba DM (2017) Simulation-based assessment of the management of critical events by board-certified anesthesiologists. Anesthesiology 127(3):475–489. https://doi.org/10.1097/ALN.0000000000001739
References
Abdu Asiri, B. A., Almutairi, R. M., Alfadhel, R. M., hawsawi, N. N. A., Faqeehi, S. M., & Alshammari, E. M. (2025). Technology-Driven Nursing Interventions to Support Telehealth in Cardiac Primary Care. Saudi Journal of Medicine and Public Health, *2*(2), 137–146. https://doi.org/10.64483/jmph-67
Alnaji, I. A. J., & Alkhaldi, A. S. M. (2024). The Integral Role of Nursing Informatics in Enhancing Patient Outcomes through the Integration of Health Information Systems in Clinical Practice: Review. Saudi Journal of Medicine and Public Health, *1*(1), 8–15. https://doi.org/10.64483/jmph-15
Anwar A, Heller KO, Esper SA, Ferreira RG (2021) Nonoperating room anesthesia: strategies to improve performance. International Anesthesiology Clinics 59(4):27–36. DOI: 10.1097/AIA.0000000000000339
Arriaga AF, Szyld D, Pian-Smith MC (2020) Real-time debriefing after critical events: exploring the gap between principle and reality. Anesthesiology Clinics 38(4):801. https://doi.org/10.1016/j.anclin.2020.08.003
Arumugam K (2023) The Role of the Community Pharmacists in the Management of Acute Pain in Adults: A Scoping Review. McGill University (Canada).
Beshbishy, A. M. (2024). Advancements in Vaccination Tracking and Delivery Systems through Health Informatics: A Review of Digital Innovations and COVID-19 Impact. Saudi Journal of Medicine and Public Health, *1*(1), 16 – 26 . https://doi.org/10.64483/jmph-16
Boet S, Larrigan S, Martin L, Liu H, Sullivan KJ, Etherington C (2018) Measuring non-technical skills of anaesthesiologists in the operating room: a systematic review of assessment tools and their measurement properties. British Journal of Anaesthesia 121(6):1218–1226. https://doi.org/10.1016/j.bja.2018.07.028
Brewster DJ, Butt WW, Gordon LJ, Sarkar MA, Begley JL, Rees CE (2023) Leadership during airway management in the intensive care unit: A video-reflexive ethnography study. Frontiers in Medicine 10:1043041. https://doi.org/10.3389/fmed.2023.1043041
Brown M, Schoen JH, Gross J, Omary RA, Hanneman K (2023) Climate change and radiology: impetus for change and a toolkit for action. Radiology 307(4):e230229. https://doi.org/10.1148/radiol.230229
Burden A, Pukenas EW (2018) Use of simulation in performance improvement. Anesthesiology Clinics 36(1):63–74. https://doi.org/10.1016/j.anclin.2017.10.001
Dieckmann P, Schmutz JB, Su L (2021) Cognition and decision making in the real world. In Comprehensive Healthcare Simulation: Improving Healthcare Systems (pp. 23–29). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-72973-8_3
Fallatah, A. R., Hawsawi, A. M. T., Makrami, R. A. H., Makrami, M. A. H., Jaber, S. A. H., Alanazi, K. S. sweet, … Al-Dosari, N. M. H. (2024). The Effect of Climate Change on Nursing: Climate Health Emergencies Preparedness Amidst Extreme Weather Conditions. Saudi Journal of Medicine and Public Health, *1*(1), 123–130. https://doi.org/10.64483/jmph-54
Gaba DM, Fish KJ, Howard SK, Burden AR (1994) Crisis Management in Anesthesiology. (No Title).
Goldhaber-Fiebert SN, Merrell SB, Agarwala AV, De La Cruz MM, Cooper JB, Howard SK, Gaba DM (2020) Clinical uses and impacts of emergency manuals during perioperative crises. Anesthesia & Analgesia 131(6):1815–1826.
Hammontree J, Kinderknecht CG (2022) An in situ mock code program in the pediatric intensive care unit: a multimodal nurse-led quality improvement initiative. Critical Care Nurse 42(2):42–55. https://doi.org/10.4037/ccn2022631
Kreuter, A. (2023). Improving Nursing Confidence Through Simulated Resuscitation Events in the Neonatal Intensive Care Unit: A Quality Improvement Project (Doctoral dissertation, Jacksonville University).
Lluch C, Galiana L, Doménech P, Sansó N (2022) The impact of the COVID-19 pandemic on burnout, compassion fatigue, and compassion satisfaction in healthcare personnel: a systematic review of the literature published during the first year of the pandemic. In Healthcare (Vol. 10, No. 2, p. 364). MDPI. https://doi.org/10.3390/healthcare10020364
Merry AF, Hannam JA, Webster CS, Edwards KE, Torrie J, Frampton C, Weller JM (2017) Retesting the hypothesis of a clinical randomized controlled trial in a simulation environment to validate anesthesia simulation in error research (the VASER Study). Anesthesiology 126(3):472–481. https://doi.org/10.1097/ALN.0000000000001514
Pasli, M., Tumin, D., & Guffey, R. (2024). Simulation‐Based Analysis of Trial Design in Regional Anesthesia. Anesthesiology Research and Practice, 2024(1), 6651894. https://doi.org/10.1155/2024/6651894
Patterson ES, Rayo MF, Edworthy JR, Moffatt-Bruce SD (2022) Applying human factors engineering to address the telemetry alarm problem in a large medical center. Human Factors 64(1):126–142. https://doi.org/10.1177/00187208211018883
Weller JM, Torrie J, Boyd M, Frengley R, Garden A, Ng WL, Frampton C (2014) Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial. British Journal of Anaesthesia 112(6):1042–1049. https://doi.org/10.1093/bja/aet579
Weinger MB, Banerjee A, Burden AR, McIvor WR, Boulet J, Cooper JB, Gaba DM (2017) Simulation-based assessment of the management of critical events by board-certified anesthesiologists. Anesthesiology 127(3):475–489. https://doi.org/10.1097/ALN.0000000000001739